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MGH

Published On May 20, 2021

POLICY

A Reckoning for Nurses and Nursing

In the isolation of the COVID-19 wards, nurses were a lifeline. Hospitals stand to benefit from their insight.

It is now possible to imagine a world recovered from COVID-19. In that future, how will medicine have changed? These 10 essays explore the technical, social and political ripples of the pandemic.

Nurses are no strangers to crisis. We dedicate ourselves to supporting people when they are at their most fragile and often sit with them in the last moment of their lives. The next day we come back, to offer our care and expertise for whoever comes through the door.

But this pandemic brought new levels of crisis and uncertainty. Many of us were working outside of our specialties. The number of clinicians who could interact with a COVID-19  patient in isolation was limited; more often than not, that clinician was one of us. We would enter a room filled with a new pathogen and be the hospital’s lifeline to a patient. And we would also be that patient’s lifeline to the world. We documented symptoms, administered experimental drugs and adjusted to unfamiliar equipment. But we also did our best to act as translators and go-betweens, to be IT consultants when a patient’s phone or other digital lifeline got buggy. We became an all-too-rare source of touch and human contact. And when we could, we tried to answer the questions of why and how and how long.

As we think about future health crises, we need to remember those demands and their lessons. A study from late October found that one in four health care workers was experiencing PTSD, and in a separate survey, eight out of 10 nurses reported disturbances in mental health. Talking among ourselves, we know this experience has, in a profound way, made us reevaluate our attitudes toward stress and burnout. We’ve gotten more serious about self-care, both individually and as institutions. Together, we've become stronger and more confident. We are learning to take our pain seriously. We are learning to open up with colleagues, our second families.  

But what we hope we’ve also learned—as a hospital, as a profession—is how important it is for all parts of the care team to listen to one another. From that vantage in the patient’s room, nurses across the country and across the world became the eyes and ears and hands of hospital practice. When insights from nurses were heard and respected, patients benefited. 

Historically, nurses have been underutilized in the decision-making of hospitals. This remains true despite studies in the United States and Sweden showing that nurse assessments of patient safety and quality of care correlated strongly with patient outcomes. Such findings underline what we already know—that nurses have a keen attention to the welfare of our patients, and when we are invited to identify problems and help find solutions, everyone benefits.

We all hope to never see another event like this, in our generation or the next. But if it happens, we will be ready to help, ready to listen, ready to share. Above all, we will be ready to stand with our teams and help our patients in the ways that serve them best.

Kristin Egan // nurse in the Surgical ICU department at MGH. Alyssa Marchant and Jessica O’Neil // nurses in the Pediatric Surgical Unit at MGH. Lisa McNeil // nurse in the Post-Surgical ICU at MGH.

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